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Intraarticular injection of bone marrow-derived mesenchymal stem cells enhances regeneration in knee osteoarthritis

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journal contribution
posted on 03.02.2020, 14:19 by Emily Claire Doyle, Nicholas Wragg, Sammy WilsonSammy Wilson
Purpose This review aimed to evaluate the efcacy of intra-articular injections of bone marrow derived mesenchymal stem cells (BM-MSCs) for the treatment of knee osteoarthritis (KOA). Methods This narrative review evaluates recent English language clinical data and published research articles between 2014 and 2019. Key word search strings of (((“bone marrow-derived mesenchymal stem cell” OR “bone marrow mesenchymal stromal cell” OR “bone marrow stromal cell”)) AND (“osteoarthritis” OR “knee osteoarthritis”)) AND (“human” OR “clinical”))) AND “intra-articular injection” were used to identify relevant articles using PMC, Cochrane Library, Web Of Science and Scopus databases. Results Pre-clinical studies have demonstrated successful, safe and encouraging results for articular cartilage repair and regeneration. This is concluded to be due to the multilineage diferential potential, immunosuppressive and self-renewal capabilities of BM-MSCs, which have shown to augment pain and improve functional outcomes. Subsequently, clinical applications of intra-articular injections of BM-MSCs are steadily increasing, with most studies demonstrating a decrease in poor cartilage index, improvements in pain, function and Quality of Life (QoL); with moderate-to-high level evidence regarding safety for therapeutic administration. However, low confdence in clinical efcacy remains due to a plethora of heterogenous methodologies utilised, resulting in challenging study comparisons. A moderate number of cells (40×106 ) were identifed as most likely to achieve optimal responses in individuals with grade ≥2 KOA. Likewise, signifcant improvements were reported when using lower (24×106 ) and higher (100×106 ) cell numbers, although adverse efects including persistent pain and swelling were a consequence. Conclusion Overall, the benefts of intra-articular injections of BM-MSCs were deemed to outweigh the adverse efects; thus, this treatment be considered as a future therapy strategy. To realise this, long-term large-scale randomised clinical trials are required to enable improved interpretations, to determine the validity of efcacy in future studies. Level of evidence IV.

History

School

  • Mechanical, Electrical and Manufacturing Engineering
  • Sport, Exercise and Health Sciences

Published in

Knee Surgery, Sports Traumatology, Arthroscopy

Volume

28

Issue

12

Pages

3827 - 3842

Publisher

Springer Science and Business Media LLC

Version

VoR (Version of Record)

Rights holder

© The authors

Publisher statement

This is an Open Access Article. It is published by Springer under the Creative Commons Attribution 4.0 Unported Licence (CC BY). Full details of this licence are available at: http://creativecommons.org/licenses/by/4.0/

Acceptance date

16/01/2020

Publication date

2020-01-31

Copyright date

2020

ISSN

0942-2056

eISSN

1433-7347

Language

en

Depositor

Dr Sammy Wilson Deposit date: 31 January 2020